Hydatid cyst of the spine : a study of 25 patients

الملخص EN

Background: The spine is rarely affected by Hydatid cyst with incidence of (1%) of all cases.

Despite advances in imaging as well as surgical and medical treatment, spine Hydatid cyst (H.C) is associated with high degree of morbidity, disability, and mortality.

Objective: To assess the clinical presentation, imaging of spine H.C.

& the outcome of surgical management regarding neurological recovery, recurrence and mortality.

Patients and Methods: This is a retrospective study of the 25 patients of spine Hydatid cyst during five years period (Jan.2010 to Jan.2015), where diagnosed and treated at medical city.

All patients after proper clinical assessment, imaging and laboratory tests had underwent posterior decompression laminactomy and removal of all Hydatid cyst without spine instrumentation.

They received Elbendazol drugs (antihelmantic drugs) for three months with follow up six months to two years.

Results: They presented with paraplegia in (48%), paraparesis of lower limbs in (32%), local pain and radiculopathy in (12%) and asymptomatic in (8%).

The spinal level was affected by hydatid cyst lumbar (64%), dorsal (24%), cervical (8%) and sacral (4%).

23 patients posterior decompression laminectomies were done, 8 patients re-do surgery and 2 patients had evacuation of subcutaneous multiple Hydatid cyst.Complete neurological recovery was achieved in (100%) of cases after primary surgery, but recurrence rate was in (21) patients (84%) and worsening of neurological status in two patients (8%).

Conclusions: Management of Hydatid cyst spine disease is challenging because of high recurrence rate, requiring aggressive and repeated surgeries with high rate of surgical complications and significant long term morbidity.Results are not satisfactory and prognosis is poor.

Keywords: Hydatid cyst, spine, recurrence, paraplegia, Elbendazole.